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Home Care & Medical Supplies and Equipment Use

Elastic Bandaging for Hemostasis after Percutaenous Transluminal Angioplasty (PTA)

  1. After the procedure, it is necessary to adequately compress the punctured artery for one hour.
  2. After the 1st hour, loosen the bandage slightly by unwrapping 1~2 circles.
  3. After the 2nd hour, loosen the bandage again slightly still unwrapping 1~2 circles.
  4. Repeat the process every 30 minutes.
  • If bleeding is found during the loosening process, rewrap the elastic bandage until there is no more active bleeding. If there is no further bleeding after 20 minutes, continue to loosening process.
  • The elastic bandage may be completely removed after having had successfully loosened the bandage 3 times in two hours without bleeding or a growing blood clot beneath the skin. Check that there is no further bleeding for 10 minutes after the elastic bandage has been removed then cover with sterile gauze.
  • Do not to perform strenuous activity or overstretch the limb six hours after PTA. Only slight wrist movement or slight bending of the knee and ankle is allowed.
  • Bandage loosening time：__________ ，__________，__________
  • Bandage removal time:______________________
  • After discharge, keep the wound clean and dry and check for wound bleeding or hematoma/blood clot underneath the skin. Try ice packing to ease any swelling or discomfort.
  • Return to the hospital or call if there are signs of poor limb circulation (fingers or toes on the punctured limb turning blue or grey or have severe numbness) Chi Mei Hospital Emergency Department Tel：（06）2812811-57161.

Figure 8 Clavicle Brace Use and Self Care

  • Most clavicle fractures can get a good therapeutic effect by using the figure-of-eight brace fixation. On rare occasions, surgeries are needed for clavicle fracture. Talk with your orthopedic surgeons during your appointment.
  • The figure 8 brace should be worn for 4~6 weeks, or even 3 months depending on your healing condition. An arm sling may be also used to ease pain during the first 2 weeks.
  • For the first 2 weeks, the figure 8 brace should be worn at all times, including sleeping and cleaning. Sponge bath is suggested. If the brace must be removed, please assume correct posture so the broken bones stay aligned. Put it back on as soon as possible after bath.
  • Do not to wear the brace outside thick clothing. Lie on your back while sleeping.
  • To put on the figure 8 brace, maintain a chest up posture, elbows out, and both hands on the waist. Allow a friend or family member to adjust the shoulders padding in a comfortable position then tighten the straps evenly. Return to the hospital if there is any discomfort.
  • Pain usually lasts 1 to 2 weeks. You may take analgesics prescribed by a physician and follow-up at the orthopedic outpatient department regularly.

Arm Sling Use and Self Care

  • Arm slings may help to alleviate the pain and to help immobilize the injured arm.
  • Adjust the sling so that the elbow is bent at an angle just less than 90 degrees.
  • Pull the triangular bandage so that it just supports the wrist. Do not let the wrist or forearm hang or droop out.
  • Keep the sling clean.
  • The sling may be temporarily removed when lying down to sleep.
  • Return to the hospital if there is any abnormal swelling, numbness or changes in the sensation of the fingers or the arm.

Cast and Splint Care

  • Like broken skin or wound, broken bones need proper time and alignment to heal. Casts and splints limit movement or immobilize the injured limb so that the bones may regenerate and repair themselves.
  • After a cast is on, you can’t remove it yourself. Your doctor will take it off.
  • Follow your doctor’s instructions for when you can first put weight on the cast. When it’s okay to put weight on your cast, do not stand or walk on it unless it is designed for walking.
  • Keep the injured limb elevated, ideally above the level of the heart, to promote circulation and relieve pain and swelling.
  • Keep the cast clean and dry.
  • Avoid eating rich or spicy food. Do not binge or overeat.
  • Practice static muscle contractions on the injured limb or small movements in the fingers and toes daily, each lasting 15 to 20 minutes and at least three times a day.
  • Also practice elevating the entire injured limb everyday. These exercises may be done on the bed or sitting on the chair.
  • Avoid hitting the cast/splint with hard materials to prevent deformation or breaking of the cast/splint.
  • Practice good hygiene and continue to clean on the hands, fingers, feet, and toes as normal as possible. Massage the limb to increase circulation from prolonged immobilization.
  • Try blowing cool air from a hair dryer or fan into the cast to help relieve itching. Never stick items under your cast to scratch the skin.
  • Don’t use oils or lotions near your cast. If the skin gets red or irritated around the edge of the cast, you may pad the edges with a soft material or use tape to cover the edges.
  • Walking aids and supports are available for rental at our rehabilitation aids center on the first floor of the 3rd medical building. Or call 2812811-53745 during business hours for more information.
  • Return to the hospital if there are the following conditions：
    1. Pain, numbness, inability to move the fingers or toes, or find the fingers or toes turning cold and purple on the limb with the cast/splint.
    2. Increasing pain or severe swelling near the cast
    3. Cast/splint broke
    4. Cast/splint feels too tight or too loose
    5. Severe discomfort of the skin underneath the cast/splint

Indwelling Foley/Urinary Catheter Care

  • A urinary catheter is a flexible plastic tube used to drain urine from the bladder when a person cannot urinate.
  • If you are helping a loved one with a catheter, try to be as relaxed as possible. Caring for a catheter can be embarrassing for both of you.
  • Always wash your hands before and after handling a catheter.
  • Clean the area around the catheter with soap and water twice a day. Change the location in which the catheter is taped or fixed on the body every day. (Male patients may have the catheter fixed on either side of his lower abdomen; female patients may have the catheter taped on either the thighs).
  • Check for inflammation or signs of infection in the area around the catheter. Signs of infection include pus or irritated, swollen, red, or tender skin.
  • Drink plenty of water to increase urine output. (Target urine output > 1500ml/day)
  • Avoid compressing, twisting, or kinking the foley catheter. Regularly squeezes the catheter to avoid obstruction.
  • Keep the urine collection bag below the level of the bladder but do not let it drag on the floor.
  • Do not apply powder or lotion to the skin around the catheter.
  • A person should not have sexual intercourse while wearing a catheter.
  • Do not attempt to remove the catheter by yourself as it may cause urethral damage.
  • Drain the collection bag when it is 2/3 full.
  • To prevent long term indwelling infection, all forms of exposed tubes and catheter must be changed regularly. In general, plain latex catheters need to be changed more frequently than silicone catheters. Follow-up regularly at the urology outpatient department or the relevant department.
  • Eating more vitamin C rich foods (such as: oranges, guava, tomatoes and papaya) may help to prevent urinary tract infections.
  • If there are a signs of urinary tract infection such as fever, chills, pain in the urethra, foul smelling urine, blood or pus in the urine, please consult a doctor immediately.
  • Other signs to consider：
    1. No urine or very little urine is flowing into the collection bag for 4 hours or more.
    2. There is new pain in the belly or pelvic area.
    3. Urine is leaking from the insertion site.

Nitroglycerin (NTG) sublingual tablet Use and Precautions

  • Take this medicine exactly as directed by your doctor.
  • Take the tablet while sitting or lying down. Nitroglycerin sublingual tablets usually provide relief within 1 to 5 minutes. If the pain is not relieved, take a second tablet 5 minutes after taking the first tablet. If the pain continues for another 5 minutes, a third tablet may be used. Contact your doctor or go to the emergency room right away if there is still have chest pain after 3 tablets.
  • Sublingual tablets should be kept in its original glass bottle. It will expire after 6 months.
  • Do not take the NTG tablet when blood pressure is lower than normal.
  • Go to the emergency room right away if there are the following conditions：
    1. Chest pain attack becoming more frequent or more severe
    2. Chest pain attack during rest
    3. Cold sweating
    4. Syncope or loss of consciousness
    5. Shortness of breath or difficulty breathing
 

Feeding Tube Care

  • Nasogastric (NG) tubes (and sometimes orogastric tubes) are inserted when the patient cannot eat or swallow. The tube goes directly from the nose (nasogastric tube) or the mouth (orogastric gubes) directly to the stomach. Once this tube is in place, it can be used to give food and medicine. It can also be used to remove things from the stomach, such as toxic substances or a sample of stomach contents.
  • NG is most commonly used for patients who have facial or neck injuries or surgeries, have a mechanical ventilator, have an intestinal obstruction or blockage, are comatose, or are at risk for choking on foods due to difficulty swallowing.
  • Feeding：
    1. Elevate the head of the bed so the patient is in a semi-upright position. Stay in this position for 1 hour after feeding.
    2. If the patient needs chest percussion, sputum aspiration or repositioning, please do these 1 hour prior to feeding.
    3. Wash your hands with soap and water.
    4. Have the feeding syringe, liquid food and warm boiled water ready and close at hand. The temperature of the feeding material should be close to body temperature.
    5. Check that the NG tube is in the correct position before beginning feeding: with the feeding syringe connected to the NG tube, slightly withdraw the plunger so that you see some gastric content run into the tube.
    6. Check patient’s digestion status：
      • The amount of residual food in the stomach should be less than 50mL when digestion is adequate. If more than 50mL remain in the stomach, you may readminister the withdrawn stomach material as long as the material is still in the tube or the syringe. There is no need to withdraw all the material in the stomach and do not readminister material that has been drained into a different vessel.
      • Deduct the approximate amount still remaining in the patient’s stomach from the coming feeding. For example, if 60mL of undigested material has been drawn but the next meal is 300mL, give 240mL or less for the next meal.
    7. Detach the syringe from the feeding tube and remove the plunger in the syringe. Clamp the tube with your fingers then open the tube plug.
    8. Attach the syringe to the tube. Carefully fill feeding formula into the syringe. Hold syringe higher than the tube and unclamp your fingers. Allow formula to run by gravity. Try not to let the syringe get empty before refilling it, as air will enter the stomach.
    9. When finished, flush the tube with the prescribed amount of warm preboiled water. Manually clamp the tube then disconnect the syringe and recap feeding tube plug.
  • Feed every 2-4 hours of approximately 200-400mL. Gradually increase the amount if necessary up to 500mL per meal. Do not force-feed.
  • Always reclamp the feeding tube plug before removing the feeding syringe to avoid leakage.
  • Flush the tube with 30~60mL of water after each feeding or taking medications, or as often as your nurse recommends.
  • Each meal should take at least 15 minutes to give a feed. Feed slowly to and allow digestion and gravity to work at its own pace. Force feeding or rushing might cause air bubbles to enter the stomach which may result in nausea and vomiting.
  • Extra drinks (boiled warm water, tea, fruit juice) can be fed between meals.
  • Feeding material is not limited to formula. Milk, juice, soy milk, vegetable juice, rice water, homemade liquid food or commercially available preparations are all possible choices. Check with your nutritionist for a balanced meal plan and preparation method.
  • Keep a diary to keep track of patient weight, intake amount, undigested amount, any changes in stool or urine, any abdominal discomfort, or anything your doctor might need to know.
  • Clean the nostrils with a wet cotton swab of grease or other discharge daily. Practice good oral hygiene and brush with a soft toothbrush and toothpaste at least twice a day.
  • Change the nostril tape everyday and apply lotion or vaseline around the nostril if necessary. Slightly twist the NG tube to prevent it adhering to stomach wall.
  • NG tubes should be changed every 7 days. Silicon NG tubes may be changed once a month.
 

Neck (Cervical) Collar Use and Care

  • Neck collars are used to protect and support the neck after an injury. Depending on the injury, the physician will provide instructions on when during the day and how long the collar should be worn. Do not remove the the collar unless instructed by your physician. Your physician will tell you if the collar may be removed when sleeping.
  • Adjust the collar so that two fingers may still be inserted between the neck and the collar to avoid compression.
  • Use a small handkerchief or gauze as a padded liner to protect the skin. Watch for reddened or broken skin under the brace. Skin breakdown can be caused by rubbing, pressure, or moisture. This may indicate that the brace does not fit properly or is not being worn properly. An orthotist can adjust the fit and provide tips for comfort and proper wear.
  • Eat easy to swallow soft foods. Avoid sticky rice products.
  • Your brace will restrict your ability to move. You will not be able to see your feet, so take care when walking.
  • Wash and deodorize your brace with a mild soap and damp cloth every day. If your brace has padded liners, let air dry or use a hair dryer on “cool” setting.

Repositioning

  • Bed-bound or immobilized patients should be repositioned every 2 hours.
  • Make sure clothes, blankets, pads or any other materials underneath the patient is flat and that there are no unnecessary materials causing excess pressure on the patient.
  • Avoid repositioning within half an hour of feeding.
  • All tubes and lines should be carefully placed to the side the patient is to be repositioned towards. Take care not to remove any tubes or lines.
  • After patient is repositioned, appropriate materials such as pillows or rolled up blankets may be used to support the limbs in a comfortable angle to avoid poor circulation or limbs dangling off the bed.
  • Use air-filled or water-filled mattresses, and gel or foam cushions to help with positioning, relieving pressure and protecting vulnerable areas from the formation of pressure sores .
  • How to reposition (e.g. Helping patient to lie on the left from lying flat)：
    1. Stand on the patient’s right and stand as close to the patient as possible. Make the bed flat. If the bed may be elevated, raise it to a level that causes minimal back strain for you.
    2. Place both arms around the patient’s shoulders and slightly lift up the patient then pull the patient towards you. Do the same with the patient’s hips so that the patient is now lying on the right side of the bed.
    3. Move to the other side and stand on the patient’s left. Fold both of the patient’s arms across his/her near chest.
    4. Place your left hand on the patient’s shoulder and your other hand on the hip.
    5. Standing with one foot ahead of the other, shift your weight to your front foot as you gently pull the patient’s shoulder toward you. Then shift your weight to your back foot as you gently pull the patient’s hip toward you.
    6. Place a pillow lengthwise under the patient’s back. Gentle pull the patient’s left shoulder towards you so the patient is slightly inclined on his/her back. Place a cushion or pillow between the patient’s knees.
    7. Make sure the patient’s ankles, knees, and elbows are not resting on top of each other. Check that the head and neck are in line with the spine, not stretched forward, back, or to the side.
分類選單

CHI MEI ER YONGKANG
No.901, Jhonghua Rd., Yongkang Dist., Tainan City 71004, Taiwan (R.O.C.)
  •  06-281-2811 #57160-4
  •  Patient Transfer Tel 06-281-6789
  •  cmh7900@mail.chimei.org.tw
CHI MEI ER LIOUYING
No.201, Taikang, Liouying Dist., Tainan City 73657, Taiwan (R.O.C.)
  •  06-622-6999 #77184-5
  •  Patient Transfer Tel 06-622-5003
  •  clh7900@mail.chimei.org.tw
CHI MEI ER CHIALI
No.606, Jialising, Jiali Dist., Tainan City 72263, Taiwan (R.O.C.)
  •  06-726-3333 #37160
  •  Patient Transfer Tel 06-7263333#37160-1
  •  cch7900@mail.chimei.org.tw